1 3 DOI 10.1007/s15010-017-0991-6 Infection ORIGINAL PAPER Pulmonary mucormycosis: clinical features and outcomes Erica Lin 1 · Teng Moua 2 · Andrew H. Limper 2 Received: 6 November 2016 / Accepted: 13 February 2017 © Springer-Verlag Berlin Heidelberg 2017 predictor. Similar survival from pulmonary mucormycosis was noted over time. Conclusions Pulmonary mucormycosis is an opportunistic angioinvasive fungal infection. Physicians must have a high level of suspicion in immunocompromised patients with fever and respiratory symptoms refractory to antibiotics. A low threshold should be had for performing an invasive procedure to gain reliable diagnosis, as early, aggressive medical and surgical interventions are needed for success- ful treatment. Keywords Fungal infection · Pulmonary mucormycosis Introduction Mucormycosis encompasses a group of opportunistic infec- tions caused by fungi in the class Zygomycetes, order Mucorales. Mucormycosis manifests in a variety of organs including rhino-orbito-cerebral, pulmonary, gastrointesti- nal, cutaneous, as well as disseminated disease. Pulmonary mucormycosis is the second most common presentation, representing up to 58% of infections [1], and is known for its aggressive clinical course with a mortality rate of up to 80% [2]. Although the condition is relatively rare, recent studies suggest that the overall incidence has increased over the past two decades [3–5]. While epidemiologic studies are challenging to conduct, available literature suggests mul- tiple reasons for this increase including rising prevalence of hematologic disorders, changes in immunosuppressive therapy and transplant practices, and earlier recognition due to increased awareness [3, 4]. As a result, mucormy- cosis has emerged as a clinically significant angioinvasive fungal infection, where recent changes in practice prompt Abstract Purpose Mucormycosis encompasses a group of oppor- tunistic fungal infections caused by Zygomycetes, order Mucorales. Mucormycosis can manifest as rhino-orbito- cerebral, pulmonary, gastrointestinal, cutaneous, and dis- seminated infections. Pulmonary mucormycosis is the second most common presentation. This manuscript char- acterizes the demographics, clinical presentation, diagnos- tic procedures, radiologic findings, therapeutic interven- tions, and outcome in pulmonary mucormycosis. Methods We retrospectively reviewed clinical data of 35 patients with pulmonary mucormycosis from 2000 to 2015. Microbiologic diagnosis was based on positive culture from a sterile site or findings on histopathology consist- ent with mucormycosis. Independent predictors of 28-day mortality were assessed using logistic regression. Survival curves were estimated using Kaplan–Meier method. Results There was male predominance with a mean age of 55 ± 15 years. Analysis of predisposing conditions revealed the prevailing presence of malignancy. Sixty- six percent of patients were receiving immunosuppres- sive agents. Common presenting clinical findings were fever, neutropenia, dyspnea, and cough. Radiologic find- ings included pleural effusion and nodules. All patients received medical therapy and 43% underwent additional surgical intervention. Twenty eight day mortality was 29% with concurrent bacteremia found as the sole independent * Teng Moua moua.teng@mayo.edu 1 Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA 2 Division of Pulmonary and Critical Care, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA